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Z406
Z406 – Scalene, posterior cervical lymph node(s), unilateral
OHIP Psychiatric Code — HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure listed under 'Haematic and Lymphatic Surgical Procedures' involving the biopsy of the scalene or posterior cervical lymph node(s). The term 'unilateral' indicates the procedure is performed on one side.
When to Use
- Use Z406 for a unilateral biopsy of a scalene or posterior cervical lymph node when performed as a distinct surgical procedure.
- Use Z406 when the clinical objective is tissue sampling of the scalene fat pad or posterior cervical chain, distinct from more extensive neck dissections like Z407.
Common Pitfalls
- Billing Z406 in conjunction with more extensive neck dissection codes (e.g., Z407) is often rejected as the biopsy is considered an inherent component of the larger procedure.
- Attempting to bill Z406 bilaterally by submitting two units will result in rejection; this code is strictly defined as unilateral and requires a bilateral indicator or separate claim handling if both sides are performed.
Billing Tips
- Ensure the operative report explicitly documents the specific lymph node chain biopsied to support the use of Z406 over general lymph node biopsy codes.
- If the procedure is performed after hours, ensure the appropriate E-series procedural premium (E409 or E410) is applied to the base fee to maximize reimbursement.
Provider Fee$247.75
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
R. Haematic and Lymphatic Surgical Procedures
Subcategory
HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Haematic and Lymphatic Surgical Procedures
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